cxcr4 pet/mri targeted imaging for grading diagnosis, molecular typing, and prognostic evaluation of brain glioma

Conditions: Glioma

Summary: this project intends to evaluate the role of c-x-c chemokine receptor type 4 (cxcr4) targeted pet/mri integrated imaging in the grading and molecular typing of brain gliomas, using primary glioma patients as the research subjects and post-operative histopathological analysis as the reference, and to establish an evaluation model for the prognosis of primary glioma patients.

1. pet/mri scan: image acquisition was completed 15 days before surgery. cxcr4 contrast agent was injected at 6.5 mbq/kg based on body mass, with no drug extravasation, and imaging was performed after 60 minutes of quiet rest. all subjects were scanned in a supine position on a single bed of the signa™ 3.0t scanner (ge healthcare systems), using a 3.0t gem hnu head coil with a scanning field of view focused on the head. pet acquisition lasted for 20 minutes and was reconstructed using osem. simultaneous mri acquisition included mr-based attenuation correction (mrac) - zero echo time pulse sequence (zte), as well as structural and functional mri sequences (t1wi, t2wi, flair, dwi, mrs, dsc, t1-ce). image fusion was performed on a ge post-processing workstation. 2. image analysis and observation indicators: pet/mri images were independently reviewed and processed by two experienced neuroradiologists. using ikt-snap software, target lesion vois were outlined based on flair and t1-ce sequences. voi delineation on the flair sequence included solid tumor components, necrotic areas, and surrounding abnormal flair signal regions. voi delineation on the t1-ce sequence included enhanced solid components, non-enhanced solid components, and necrotic areas. mri parameters (diffusion-weighted imaging parameters: adc; perfusion imaging parameters: cbf, cbv, mtt, ttp; spectroscopic parameters: naa, cho, cr, lac, naa/cr, cho/cr) and pet parameters (suvmax, suvmean, suvpeak, cxcr4 metabolic volume, tbr) were measured throughout the tumor and corresponding regions. 3. pathological analysis: slices containing no less than 25% tumor tissue were used, with each slice having a thickness of 4um. he, cd34, and cxcr4 immunohistochemical staining were performed separately. two senior pathologists reviewed the slides using a double-blind method. idh mutation status and 1p/19q deletion status were determined by the pathology department.

Eligibility criteria:
inclusion criteria: 1. patients diagnosed with primary glioma based on clinical, imaging, and histopathological criteria; 2. the patient is at least 18 years old; 3. participate in cxcr4 pet/mri imaging within 15 days before surgery; 4. surgical resection of glioma lesion tissue can be used for pathological analysis; 5. the patient voluntarily participates and signs the informed consent form. exclusion criteria: 1. pregnant or breastfeeding patients; 2. the image quality of the imaging is poor and cannot be used for diagnosis and evaluation; 3. molecular typing was not determined by histologic examination; 4. patients with claustrophobia; 5. patients who are allergic to radioactive tracers and mri contrast agents, and patients with renal insufficiency.